Neurocytoma of the cauda equina

Case report

Restricted access

✓ A case of a neurocytoma involving a nerve root of the cauda equina in a 46-year-old woman is reported. The patient presented with a 2-month history of progressive left lower-extremity weakness and pain and decreased ability to walk, as well as complaints of incomplete voiding. A magnetic resonance image revealed a 7-mm oval mass that was located intrathecally and extended from T-12 to L-1 and was adjacent to a nerve root. No lesions were identified at higher vertebral levels. The mass was excised. On histological examination it was found to have classical features of a neurocytoma. To the best of the authors' knowledge, this is the first report of a neurocytoma occurring in that region. A detailed histological description of this case and review of the pertinent literature are provided.

Article Information

Address reprint requests to: Christina L. Stephan, Post-Sophomore Fellow, Department of Pathology and Laboratory Medicine, University of Kansas School of Medicine, 3901 Rainbow Boulevard, Kansas City, Kansas 66160-7410.

© AANS, except where prohibited by US copyright law.

Headings

Figures

  • View in gallery

    Magnetic resonance images. Upper: Gadolinium-enhanced image showing the tumor (arrow) a few centimeters below the conus medullaris. Lower: T2-weighted axial image revealing the tumor (arrowhead) within the cauda equina.

  • View in gallery

    Photomicrographs of the tumor. Upper Left: A portion of the tumor shows scattered small round cells with their cytoplasm blending into an eosinophilic fibrillary background and larger islands of the latter (right-hand lower corner) resembling neuropil. H & E, original magnification × 120. Upper Right: In this area, the tumor cell nuclei form parallel rows, separated by a fibrillary background. H & E, original magnification × 130. Center Left: In many tumor cell nuclei the chromatin substance is arranged in a speckled “salt-and-pepper” pattern. Hematoxylin with little eosin added, original magnification × 200. Center Right: The tumor was free of reticulin fibrils; only the basement membranes of blood vessels (center of image) stained for reticulin. Wilder's stain for reticulum, original magnification × 130. Lower Left: The cytoplasm of some tumor cells stained positively for synaptophysin. Immunoperoxidase stain for synaptophysin, original magnification × 140. Lower right: Long tapering cytoplasmic processes of some tumor cells resembled formation of dendrites and axons. Immunoperoxidase stain for gamma enolase (“neuron-specific enolase”), original magnification × 150.

References

  • 1.

    Agranovich ALAng LCFryer CH: Central neurocytoma: report of 2 cases and literature review. J Neurooncol 16:47531993Agranovich AL Ang LC Fryer CH: Central neurocytoma: report of 2 cases and literature review. J Neurooncol 16:47–53 1993

  • 2.

    Burger PCScheithauer BW: Tumors of the central nervous system in Rosai JSobin LH (eds): Atlas of Tumor PathologyThird Series. Washington DC: Armed Forces Institute of Pathology1992196200Burger PC Scheithauer BW: Tumors of the central nervous system in Rosai J Sobin LH (eds): Atlas of Tumor Pathology Third Series. Washington DC: Armed Forces Institute of Pathology 1992 196–200

  • 3.

    Cerda-Nicolas MLopez-Gines CPeydro-Olaya Aet al: Central neurocytoma: a cytogenetic case study. Cancer Genet Cytogenet 65:1731741993Cerda-Nicolas M Lopez-Gines C Peydro-Olaya A et al: Central neurocytoma: a cytogenetic case study. Cancer Genet Cytogenet 65:173–174 1993

  • 4.

    Coca SMoreno MMartos JAet al: Neurocytoma of spinal cord. Acta Neuropathol 87:5375401994Coca S Moreno M Martos JA et al: Neurocytoma of spinal cord. Acta Neuropathol 87:537–540 1994

  • 5.

    Enam SARosenblum MLHo KL: Neurocytoma of the cerebellum: case report. J Neurosurg 87:1001021997Enam SA Rosenblum ML Ho KL: Neurocytoma of the cerebellum: case report. J Neurosurg 87:100–102 1997

  • 6.

    Eng DYDeMonte FGinsberg L et al: Craniospinal dissemination of central neurocytoma: report of two cases. J Neurosurg 86:5475521997Eng DY DeMonte F Ginsberg L et al: Craniospinal dissemination of central neurocytoma: report of two cases. J Neurosurg 86:547–552 1997

  • 7.

    Figarella-Branger DPellissier JFDaumas-Duport Cet al: Central neurocytomas: critical evaluation of a small cell neuronal tumor. Am J Surg Pathol 16:971091992Figarella-Branger D Pellissier JF Daumas-Duport C et al: Central neurocytomas: critical evaluation of a small cell neuronal tumor. Am J Surg Pathol 16:97–109 1992

  • 8.

    Giangaspero FCenacchi GLosi Let al: Extraventricular neoplasms with neurocytoma features: a clinicopathological study of 11 cases. Am J Surg Pathol 21:2062121997Giangaspero F Cenacchi G Losi L et al: Extraventricular neoplasms with neurocytoma features: a clinicopathological study of 11 cases. Am J Surg Pathol 21:206–212 1997

  • 9.

    Hassoun JGambarelli DGrisoli Fet al: Central neurocytoma: an electron-microscopic study of two cases. Acta Neuropathol 56:1511561982Hassoun J Gambarelli D Grisoli F et al: Central neurocytoma: an electron-microscopic study of two cases. Acta Neuropathol 56:151–156 1982

  • 10.

    Hessler RBLopez MSFrankfurter Aet al: Cytoskeletal immunohistochemistry of central neurocytomas. Am J Surg Pathol 16:103110381992Hessler RB Lopez MS Frankfurter A et al: Cytoskeletal immunohistochemistry of central neurocytomas. Am J Surg Pathol 16:1031–1038 1992

  • 11.

    Kasantikul VPalmer JONetsky MGet al: Glioma of the acoustic nerve. Arch Otolaryngol 106:4564591980Kasantikul V Palmer JO Netsky MG et al: Glioma of the acoustic nerve. Arch Otolaryngol 106:456–459 1980

  • 12.

    Louis DNSwearingen BLinggodd RMet al: Central nervous system neurocytoma and neuroblastoma in adults—report of eight cases. J Neurooncol 9:2312381990Louis DN Swearingen B Linggodd RM et al: Central nervous system neurocytoma and neuroblastoma in adults—report of eight cases. J Neurooncol 9:231–238 1990

  • 13.

    Miller DCKim RZagzag D: Neurocytomas: non-classical sites and mixed elements. J Neuropathol Exp Neurol 51:3641982Miller DC Kim R Zagzag D: Neurocytomas: non-classical sites and mixed elements. J Neuropathol Exp Neurol 51:364 1982

  • 14.

    Ng HKKo HWTse CH: Immunohistochemical and ultrastructural studies of oligodendrogliomas revealed features of neuronal differentiation. Int J Surg Pathol 2:47551994Ng HK Ko HW Tse CH: Immunohistochemical and ultrastructural studies of oligodendrogliomas revealed features of neuronal differentiation. Int J Surg Pathol 2:47–55 1994

  • 15.

    Pearl GSTakei UBakay REet al: Intraventricular primary cerebral neuroblastoma in adults: report of three cases. Neurosurg 16:8478491985Pearl GS Takei U Bakay RE et al: Intraventricular primary cerebral neuroblastoma in adults: report of three cases. Neurosurg 16:847–849 1985

  • 16.

    Reifenberger GBoström JBettag Met al: Primary glioblastoma multiforme of the oculomotor nerve: case report. J Neurosurg 84:106210661996Reifenberger G Boström J Bettag M et al: Primary glioblastoma multiforme of the oculomotor nerve: case report. J Neurosurg 84:1062–1066 1996

  • 17.

    Sceats DJQuisling RRhoton AL Jret al: Primary leptomeningeal glioma mimicking an acoustic neuroma: case report with review of the literature. Neurosurgery 19:6496541986Sceats DJ Quisling R Rhoton AL Jr et al: Primary leptomeningeal glioma mimicking an acoustic neuroma: case report with review of the literature. Neurosurgery 19:649–654 1986

  • 18.

    Schweitzer JBDavies MB: Differentiating central neurocytoma: case report. J Neurosurg 86:5435461997Schweitzer JB Davies MB: Differentiating central neurocytoma: case report. J Neurosurg 86:543–546 1997

  • 19.

    Söylemezoglu FScheithauer BWEsteve Jet al: Atypical central neurocytoma. J Neuropathol Exp Neurol 56:5515561997Söylemezoglu F Scheithauer BW Esteve J et al: Atypical central neurocytoma. J Neuropathol Exp Neurol 56:551–556 1997

  • 20.

    Tatter SBBorges LFLouis DN: Central neurocytomas of the cervical spinal cord: report of two cases. J Neurosurg 81:2882931994Tatter SB Borges LF Louis DN: Central neurocytomas of the cervical spinal cord: report of two cases. J Neurosurg 81:288–293 1994

  • 21.

    Valdueza JMWestphal MVorthmeyer Aet al: Central neurocytoma: clinical, immunohistologic and biologic findings of a human neuroglial progenitor tumor. Surg Neurol 45:49561996Valdueza JM Westphal M Vorthmeyer A et al: Central neurocytoma: clinical immunohistologic and biologic findings of a human neuroglial progenitor tumor. Surg Neurol 45:49–56 1996

  • 22.

    von Deimling AKleihues PSaremaslam Pet al: Histogenesis and differentiation potential of central neurocytoma. Lab Invest 64:5855911991von Deimling A Kleihues P Saremaslam P et al: Histogenesis and differentiation potential of central neurocytoma. Lab Invest 64:585–591 1991

  • 23.

    Yamamoto TKomori TShibata N: Multifocal neurocytomagangliocytoma with extensive leptomeningeal dissemination in the brain and spinal cord. Am J Surg Pathol 20:3633701996Yamamoto T Komori T Shibata N: Multifocal neurocytomagangliocytoma with extensive leptomeningeal dissemination in the brain and spinal cord. Am J Surg Pathol 20:363–370 1996

  • 24.

    Yaşargil MGvon Ammon Kvon Deimling Aet al: Central neurocytoma: histopathological variants and therapeutic approaches. J Neurosurg 76:32371992Yaşargil MG von Ammon K von Deimling A et al: Central neurocytoma: histopathological variants and therapeutic approaches. J Neurosurg 76:32–37 1992

TrendMD

Metrics

Metrics

All Time Past Year Past 30 Days
Abstract Views 47 47 10
Full Text Views 54 54 0
PDF Downloads 84 84 0
EPUB Downloads 0 0 0

PubMed

Google Scholar